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Remote RN Medical Reviewer II – Utilization & Claims
Remote / Online - Candidates ideally in
Northern, Floyd County, Kentucky, USA
Listed on 2026-08-22
Northern, Floyd County, Kentucky, USA
Listing for:
Southcarolinablues
Full Time, Remote/Work from Home
position Listed on 2026-08-22
Job specializations:
-
Nursing
RN Nurse, Healthcare Nursing
Job Description & How to Apply Below
Palmetto GBA, a Blue Cross Blue Shield South Carolina subsidiary, seeks a Medical Reviewer II (RN) to perform medical claim reviews and determine medical necessity using established guidelines. The role documents decisions and supports utilization review across multiple services.
The position is remote, full-time, with standard hours 8:00 AM–5:00 PM ET, training, and potential overtime. RN license, associate degree, and 2+ years of clinical RN experience required.
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